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E-health sites ready consumer pile-on

Six-week delay to live implementation.

The Federal Government's decision to halt work at preliminary sites testing components of the personally controlled electronic health record have cost the project a further six weeks delay, according to one of the sites involved.

Metro North Brisbane Medicare Local chief executive Abbe Anderson told a Senate inquiry inspecting legislation for the e-health project that her implementation site now planned to sign up the first consumers to test live shared health summaries in mid-March, rather than January 30 as previously planned.

The delay comes after ten of 12 implementation sites were told by the National E-Health Transition Authority (NEHTA) on January 19 to halt work on "primary care desktop software development" due to "technical incompatibilities across versions" of the specifications provided to the sites in November last year.

Though none of the software affected by the issue had been pushed live to patients at the time, one report suggested NEHTA told heads of the implementation sites affected last week that there was a "potential clinical risk" if work went ahead using the specifications supplied.

After a year's preparation, the first three sites chosen to test PCEHR components in Queensland, NSW and Victoria plan to recruit "tens of thousands" of consumers to the live systems ahead of the PCEHR deadline on July 1.

Though NEHTA and the Department of Health and Ageing initially planned to have all 12 wave sites complete implementation and testing of systems by April, it is expected the wave sites will continue well into the next few months, putting pressure on the Government to meet its stated deadline.

The sites are yet to sign a revised transition contract overseeing movement of implementation work done at each of the sites to the national infrastructure being stood up by a consortium of vendors led by Accenture.

Adam McLeod, director of e-health and business strategy at the Inner Melbourne East Medicare Local, said that, "barring significant changes that come out of [the specification issue], we think we've got something that's ready to go".

"We have repositories set up in each of our jurisdictions, and we've basically been testing the software to a point where we feel it's ready to go," he said.

Each GP clinic involved in the trial will be able to nominate a specific demographic - such as those with chronic illness or in aged care - to test the shared health summary in their area.

Consumers who choose to participate in the trial will be given a "placeholder" shared health summary, which a GP will then be able to populate with historic and current health data.

Each site is tasked with testing and implementing a specific portion of the infrastructure and processes expected to be in place for the national PCEHR initiative, with some sites focusing on particular consumer demographics including indigenous and aged care, or mothers with newborns.

The tests, according to Anderson, were to "discover and feedback and resolve the inevitable problems that there are with those various systems and processes".

"It's not really sensible to implement such a complex system across the whole of the nation without having tested somewhere first," she said.

In a submission [pdf] to the Senate inquiry, NSW Health indicated it planned to implement discharge summaries and specialist letters at participating practices in one of its sites last month.

A patient registry involved more than 1.8 million patient demographic records had also been implemented at the second wave site, building on work done during a long-running state trial of electronic health records.

A spokeswoman did not return a request for comment on the current state of implementation, given the specification issue.

Department of Health and Ageing deputy secretary Rosemary Huxtable told the Senate committee yesterday that national infrastructure elements required to stand up and allow for registration of the PCEHR were "on track" for the July 1 deadline.

But others fronting the inquiry remained unsure the Federal Government would reach the July 1 milestone.

Anderson told the inquiry that a delay in the implementation of the national PCEHR past July should have no immediate effect on the wave sites, provided those sites were permitted to continue using the systems put in place as part of the implementation phase.

"If it's delayed, that depends on whether we'd be allowed to continue working with the local system we have," she said.

But the future of the project, which has yet to receive government funding past July 1, remained in doubt.

"Clearly there's discussions with Government and within Government on future funding... we are planning and discussing," Huxtable said.

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